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Ohio BWC: Formulary Driving Decline in Opioid Prescriptions

May 22, 2015 - WorkCompWire

Columbus, OH – A new report details the success of the Ohio Bureau of Workers’ Compensation (BWC) first-ever outpatient medication formulary, as well as future steps BWC will take to protect injured workers from deadly drug regimens. Injured workers were prescribed 15.7 million fewer opiate doses in 2014 than in 2010, representing a 37 percent decrease. BWC implemented the closed formulary in 2011 to improve the efficiency and effectiveness of treatment, limit inappropriate uses of medications and lower prescription costs.

“Our goal is to ensure injured workers in Ohio are receiving effective, clinically grounded treatments that help them heal while protecting their well-being so they can regain their footing and return to work whenever possible,” said BWC Administrator/CEO Steve Buehrer. “Prescription medications should assist in recovery following a workplace injury, and we’ve put safeguards in place because no one should suffer from addiction or an unintentional overdose while trying to get back on their feet.”

The report was delivered by John Hanna, BWC’s pharmacy program director, during the fourth annual National RX Drug Abuse Summit in Atlanta, Georgia. Hanna provided the national audience an overview of the BWC formulary, and discussed the impact it’s had on drug and opiate use by injured workers since it went into effect in September 2011.

After implementing the formulary, BWC began refining coverage for opiates as well as coverage of muscle relaxants and anti-ulcer agents, which are also commonly overprescribed and misused. Over that period of time, prescriptions for muscle relaxants and anti-ulcer medications decreased by 72 percent and 83 percent.

“Our focus when implementing the formulary and making subsequent changes has been on the clinical rationale, and BWC’s goal of ensuring the medications injured workers receive following their injury do not ultimately hinder their recovery,” said Hanna.

Hanna stressed that injured workers can face risks beyond those posed by opiates. Moving forward, BWC will be targeting dangerous combinations of medications prescribed by multiple physicians. After detecting those at the highest risk, BWC will work with their physicians or make referrals to managed care organizations to ensure injured workers aren’t receiving medication combinations that can be deadly. BWC will be studying its data about injured worker medication and hopes to present early findings to its pharmacy and therapeutics committee this summer.

Ongoing improvements to the pharmacy program have also produced dollar savings. In 2014, BWC’s total drug costs were 16 percent, or $20.7 million, less than in 2010. Opiate costs were down 36 percent ($19.9 million); muscle relaxant costs were down 78 percent ($3.3 million); and anti-ulcer costs were down 95 percent ($6.4 million).

With 859,000 open claims, BWC is the largest state fund workers’ compensation insurer in the country. The agency paid $1.7 billion in total benefits during fiscal year 2014, including $662 million in medical spending and $109 million in pharmacy benefits.

Source: Ohio BWC

Filed Under: Association, Rating & Research News, Industry News, Legislative & Regulatory News, Top Stories, Workers' Compensation

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